Reduced renal function strongly affects survival and thrombosis in patients with myelofibrosis

Lucijanić, Marko; Galušić, Davor; Krečak, Ivan; Sedinić, Martina; Holik, Hrvoje; Periša, Vlatka; Perić, Martina Morić; Zekanović, Ivan; Štoos‐Veić, Tajana; Kušec, Rajko

doi:10.1007/s00277-020-04239-4

Cited by 30 publications

(20 citation statements)

References 26 publications

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“…Comorbidities can affect the rate of thrombotic and hemorrhagic complications in MPN patients. For example, kidney dysfunction has been associated with an increased risk of thrombosis in MPN [ 9 , 57 , 58 ]. However, whether comorbidities also affect the rate of progression in MPN patients is largely unknown.…”

Section: Etiology Of Mpn Progressionmentioning

confidence: 99%

Progression of Myeloproliferative Neoplasms (MPN): Diagnostic and Therapeutic Perspectives

Baumeister

Chatain

Sofias

et al. 2021

Cells

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Classical BCR-ABL-negative myeloproliferative neoplasms (MPN) are a heterogeneous group of hematologic malignancies, including essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF), as well as post-PV-MF and post-ET-MF. Progression to more symptomatic disease, such as overt MF or acute leukemia, represents one of the major causes of morbidity and mortality. There are clinically evident but also subclinical types of MPN progression. Clinically evident progression includes evolution from ET to PV, ET to post-ET-MF, PV to post-PV-MF, or pre-PMF to overt PMF, and transformation of any of these subtypes to myelodysplastic neoplasms or acute leukemia. Thrombosis, major hemorrhage, severe infections, or increasing symptom burden (e.g., pruritus, night sweats) may herald progression. Subclinical types of progression may include increases in the extent of bone marrow fibrosis, increases of driver gene mutational allele burden, and clonal evolution. The underlying causes of MPN progression are diverse and can be attributed to genetic alterations and chronic inflammation. Particularly, bystander mutations in genes encoding epigenetic regulators or splicing factors were associated with progression. Finally, comorbidities such as systemic inflammation, cardiovascular diseases, and organ fibrosis may augment the risk of progression. The aim of this review was to discuss types and mechanisms of MPN progression and how their knowledge might improve risk stratification and therapeutic intervention. In view of these aspects, we discuss the potential benefits of early diagnosis using molecular and functional imaging and exploitable therapeutic strategies that may prevent progression, but also highlight current challenges and methodological pitfalls.

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Section: Etiology Of Mpn Progressionmentioning

confidence: 99%

Progression of Myeloproliferative Neoplasms (MPN): Diagnostic and Therapeutic Perspectives

Baumeister

Chatain

Sofias

et al. 2021

Cells

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“…Therefore, this study signals that PLR could be a novel prognostic biomarker in PV patients and again highlights the detrimental effect of CKD on both thrombosis and OS in PV. 10,11 Interestingly, these two variables outperformed NLR, older age, high-risk disease, and baseline lymphocyte, neutrophil, and platelet counts, most probably due to their overlapping prognostic properties. Notably, higher platelet counts were univariately associated with both shorter TTT and an inferior OS, whereas lymphopenia only correlated with a shorter TTT; therefore, it seems that the effect of PLR on TTT is driven by both higher platelet counts and lymphopenia.…”

Section: Neutrophil-to-lymphocyteandplatelet-to-lymphocyteratiosas Pr...mentioning

confidence: 99%

Neutrophil‐to‐lymphocyte and platelet‐to‐lymphocyte ratios as prognostic biomarkers in polycythemia vera

Krečak

Holik

Perić

et al. 2021

Int J Lab Hematology

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“…In the general population, there is evidence for a link between thrombosis, inflammation, chronic kidney disease (CKD), and survival [13][14][15][16][17][18][19][20]. CKD occurs significantly more frequently in MPN patients than in the general population, as documented by renal involvement in several case studies [21][22][23] as well as larger monocenter [24,25] or oligocentric studies [26,27]. These studies have shown that CKD is associated with thrombosis in MPN patients [26] and that kidney function declines with MPN duration beyond the expected age-related decline, suggesting that the MPN itself has a deteriorating impact on kidney function [2,24,26].…”

Section: Introductionmentioning

confidence: 99%

Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry

Gecht

Tsoukakis

Kricheldorf

et al. 2021

Cancers

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Inflammation-induced thrombosis represents a severe complication in patients with myeloproliferative neoplasms (MPN) and in those with kidney dysfunction. Overlapping disease-specific attributes suggest common mechanisms involved in MPN pathogenesis, kidney dysfunction, and thrombosis. Data from 1420 patients with essential thrombocythemia (ET, 33.7%), polycythemia vera (PV, 38.5%), and myelofibrosis (MF, 27.9%) were extracted from the bioregistry of the German Study Group for MPN. The total cohort was subdivided according to the calculated estimated glomerular filtration rate (eGFR, (mL/min/1.73 m2)) into eGFR1 (≥90, 21%), eGFR2 (60–89, 56%), and eGFR3 (<60, 22%). A total of 29% of the patients had a history of thrombosis. A higher rate of thrombosis and longer MPN duration was observed in eGFR3 than in eGFR2 and eGFR1. Kidney dysfunction occurred earlier in ET than in PV or MF. Multiple logistic regression analysis identified arterial hypertension, MPN treatment, increased uric acid, and lactate dehydrogenase levels as risk factors for kidney dysfunction in MPN patients. Risk factors for thrombosis included arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The risk factors for kidney dysfunction and thrombosis varied between MPN subtypes. Physicians should be aware of the increased risk for kidney disease in MPN patients, which warrants closer monitoring and, possibly, early thromboprophylaxis.

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Reduced renal function strongly affects survival and thrombosis in patients with myelofibrosis

Cited by 30 publications

References 26 publications

Progression of Myeloproliferative Neoplasms (MPN): Diagnostic and Therapeutic Perspectives

Progression of Myeloproliferative Neoplasms (MPN): Diagnostic and Therapeutic Perspectives

Neutrophil‐to‐lymphocyte and platelet‐to‐lymphocyte ratios as prognostic biomarkers in polycythemia vera

Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry

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